NAIROBI (Thomson Reuters Foundation) - Mother of four
Everlyn Irusa was given an injection to numb her inside upper
arm before two four-centimeter-long rods were inserted just
under her skin.

Irusa, 37, was being fitted with a contraceptive implant to
prevent pregnancy for up to five years. She had decided the
implant would suit her better than injectable contraceptives,
which last three months and require regular clinic appointments.

"I decided to use this one because I'm not always able to
come to the clinic," she said, after having the implant inserted
at a government clinic. "It'll give me more time between
visits."

Irusa lives in Nairobi's Mathare slum and makes a living
from selling vegetables by the roadside. Her youngest child is
four years old and she does not want any more children.

Implants, which release a hormone into the body to stop the
ovaries releasing eggs, are used by less than two percent of the
600 million women in developing countries who use modern
contraceptives. In the past, they have often not been available,
nor have health workers been trained to fit them.

There have also been concerns about side effects, such as
irregular menstrual bleeding, nausea, headaches and depression,
which prompted legal suits in the United States.

But experts are trying to encourage more women to adopt
these longer-lasting contraceptive methods because they do not
require repeated visits to health clinics, are cheaper and more
effective at preventing pregnancy - 99 percent effective when
inserted correctly.

PHARMACEUTICAL DEALS

Implant use in Kenya has risen from zero in 1999 to almost
five percent in 2008, according to USAID. A price reduction
agreed this year is likely to further increase availability and
use.

In February, the Gates Foundation signed a deal with
pharmaceutical company Bayer for it to make Jadelle - a
contraceptive implant that lasts up to five years - available to
27 million women in the world's poorest countries over the next
six years.

The implants are being sold to governments and international
organizations like the United Nations Population Fund (UNFPA)
for $8.50 a unit, down from $18.

"We are proud to play our role in helping to avoid almost 30
million unintended pregnancies while averting some 280,000
infant and 30,000 maternal deaths as a direct benefit of the
Jadelle Access Program," said Klaus Brill, vice president of
corporate commercial relations at Bayer, at a press conference
in Nairobi on Thursday.

The Gates Foundation agreed on a similar partnership with
Merck Sharp and Dohme, which has reduced the price of Implanon,
its three-year contraceptive implant, by 50 percent over the
next six years.

Family planning services are free in government facilities
across Kenya but the price reduction means the government's
budget for contraceptives will stretch further.

In Nairobi, condoms are the most popular form of
contraceptive, used by 40 percent of clients in government
clinics. Injections are the second most popular, followed by
pills.

There was a 52 percent increase in demand for implants in
2012, compared to 2011, according to government statistics.
Condom, coil and injection use increased by 13 percent while
that of microgynon pills and bilateral tubal litigation - a
permanent form of birth control that involves blocking a woman's
fallopian tubes - increased by 10 percent.

"We are trying to promote the long acting reversible
contraceptive methods," said Moses Owino, a medical officer at
Mathare North health clinic. "It's more convenient for the
mother as she doesn't have to come (to a clinic) every time."